Communication to Consumers

States often set standards for a managed care organization’s (MCO’s) telephone help lines. These standards frequently require calls to be answered within a certain number of rings, and prohibit consumers from being put on hold for more than a specified number of minutes.

Contracts often require advance approval from the state for written materials such as member handbooks. For instance, Wisconsin requires review of certain written materials by a group that must include consumer representatives.

MCO may not require participating providers to distribute MCO-prepared communications to patients: New York bbb

Residential services providers may not conduct marketing that focuses on ability of MCO programs to pay for services from provider after consumer has exhausted private financial resources: Wisconsin ccc